The key reference site for travel vaccination and malaria prophylaxis is the CDC. CDC Traveller Destination Recommendations.
Travel Vaccines
Here is a table summarizing travel vaccines, grouped by condition, product, dose schedule, and the route of administration, based on Australian brand names:
| Condition | Product | Dose Schedule (Regular) | Dose Schedule (Accelerated) | Route |
|---|---|---|---|---|
| Hepatitis A | Havrix 1440 | 2 doses: 0, 6-12 months | Not applicable | IM |
| Vaqta Adult 50U | 2 doses: 0, 6-12 months | Not applicable | IM | |
| Twinrix (A+B) | 3 doses: 0, 1, 6 months | Not applicable for Hepatitis A alone | IM | |
| Hepatitis B | Engerix-B | 3 doses: 0, 1, 6 months | 4 doses: 0, 7, 21 days + booster at 12 months | IM |
| Twinrix (A+B) | 3 doses: 0, 1, 6 months | 4 doses: 0, 7, 21 days + booster at 12 months | IM | |
| Typhoid | Typhim Vi | Single dose, booster every 2-3 years | Not applicable | IM |
| Vivotif | 4 capsules: one every 2 days, finish 1 week before travel | Not applicable | Oral | |
| Yellow Fever | Stamaril | Single dose, lifelong protection | Not applicable | S/C or IM |
| Japanese Encephalitis | Ixiaro | 2 doses: 0, 28 days | 2 doses: 0, 7 days (for adults 18-65 years) | IM |
| Rabies | Rabipur | 3 doses: 0, 7, 21 or 28 days | Same as regular dosing | IM |
| Verorab | 3 doses: 0, 7, 21 or 28 days | Same as regular dosing | IM | |
| Cholera (and ETEC) | Dukoral | 2 doses, 1-6 weeks apart | 2 doses, 1 week apart | Oral |
| Meningococcal (A, C, W, Y) | Menveo | Single dose, booster every 5 years | Not applicable | IM |
| Nimenrix | Single dose, booster every 5 years | Not applicable | IM | |
| Tick-Borne Encephalitis | FSME-Immun | 3 doses: 0, 1-3 months, 5-12 months | 3 doses: 0, 14 days, 5-12 months | IM |
| Polio (IPV) | IPOL | Single booster if previously vaccinated, booster every 10 years | Not applicable | IM |
| Measles, Mumps, Rubella (MMR) | MMR II or Priorix | 2 doses, at least 28 days apart | Same as regular | S/C |
| Tetanus, Diphtheria, Pertussis (Tdap) | Boostrix | Single booster every 10 years | Not applicable | IM |
Malaria Prophylaxis
Here is the updated table for Malaria prophylaxis options, including the product, dose schedule, and geographical areas where the regimen should not be used due to resistance:
| Product | Dose Schedule (Regular) | Geographical Areas Where Not Recommended (Due to Resistance) | Route |
|---|---|---|---|
| Atovaquone/Proguanil (Malarone) | 1 tablet daily, start 1-2 days before travel, continue during travel, and for 7 days after leaving the area | Generally effective worldwide, but use caution in areas with high parasite resistance like parts of Southeast Asia | Oral |
| Doxycycline | 1 tablet (100 mg) daily, start 1-2 days before travel, continue during travel, and for 4 weeks after leaving the area | Resistance is not a concern, but avoid in certain populations (e.g., pregnant women and children under 8 years) | Oral |
| Mefloquine (Lariam) | 1 tablet (250 mg) weekly, start 2-3 weeks before travel, continue during travel, and for 4 weeks after leaving the area | Widespread resistance in Southeast Asia, especially along the borders of Thailand, Myanmar, Laos, and Cambodia | Oral |
| Chloroquine | 1 tablet (300 mg) weekly, start 1-2 weeks before travel, continue during travel, and for 4 weeks after leaving the area | Widespread resistance in Sub-Saharan Africa, South Asia, and parts of Southeast Asia and South America | Oral |
| Primaquine | 2 tablets (15 mg each) daily, start 1-2 days before travel, continue during travel, and for 7 days after leaving the area | Not applicable for P. falciparum-endemic areas; requires G6PD testing before use in any area | Oral |
Key Notes on Resistance:
- Atovaquone/Proguanil (Malarone) is broadly effective but may face increasing resistance in areas with high malaria transmission, particularly in parts of Southeast Asia.
- Doxycycline does not have widespread resistance, making it a reliable option across most malaria-endemic regions.
- Mefloquine (Lariam) should not be used in certain areas of Southeast Asia due to high levels of resistance.
- Chloroquine has been rendered ineffective in much of the world due to resistance, especially in Africa, India, and Southeast Asia.
- Primaquine is not used for P. falciparum prevention but is useful for P. vivax; it requires pre-screening for G6PD deficiency and is not typically affected by drug resistance.
Helminth Infection
Here is a table summarizing helminth infection prophylaxis or treatment recommendations, including the product, dose schedule, and geographical areas where the regimen should not be used due to resistance or other concerns:
| Product | Dose Schedule (Regular) | Geographical Areas Where Not Recommended (Due to Resistance or Concerns) | Route |
|---|---|---|---|
| Albendazole | Single dose (400 mg) for most helminth infections (repeat in 2 weeks for some infections) | Resistance can occur in areas with heavy use, but still widely effective in most regions | Oral |
| Mebendazole | Single dose (100-500 mg) for most helminth infections (repeat in 2-3 weeks if necessary) | Resistance reported in parts of West Africa for some parasites; still widely effective elsewhere | Oral |
| Ivermectin | Single dose (150-200 mcg/kg) for Strongyloides, Onchocerciasis, and other helminth infections | May have reduced efficacy in regions with high Onchocerciasis prevalence due to partial resistance, such as parts of West Africa | Oral |
| Praziquantel | 20 mg/kg for Schistosomiasis and tapeworm infections (single dose or divided dose over a day) | Resistance is rare but reported in areas with high endemic Schistosomiasis, such as parts of Africa | Oral |
| Diethylcarbamazine (DEC) | 6 mg/kg daily for 12 days for Lymphatic Filariasis | Not recommended in areas where Onchocerciasis is co-endemic (such as parts of Africa) due to severe side effects from co-infection | Oral |
| Pyrantel Pamoate | Single dose (10 mg/kg) for hookworm, roundworm, and pinworm infections; may require repeat dosing | No significant resistance concerns globally, still effective in most areas | Oral |
Key Notes on Resistance and Use:
- Albendazole and Mebendazole are the first-line treatments for most intestinal helminths. While some resistance has been reported, these medications are still effective in most regions.
- Ivermectin is highly effective for Strongyloides and Onchocerciasis, but resistance is emerging in certain West African regions, especially where Onchocerciasis is common.
- Praziquantel remains the main treatment for Schistosomiasis, though partial resistance has been observed in heavily endemic areas of Africa.
- Diethylcarbamazine (DEC) is a standard treatment for Lymphatic Filariasis, but it should be avoided in regions co-endemic with Onchocerciasis, where it can cause severe adverse reactions.
- Pyrantel Pamoate is effective against common intestinal worms and has no significant global resistance patterns, making it a reliable choice.
These recommendations are region-dependent and should be adapted based on specific travel destinations and the prevalence of resistant helminths.